How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,380 to $7,244Professionalmedian $324 · 10th to 90th $23 to $759
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $933.25 | Professional | None | $549.54 | $660.69 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $1,148.15 | Professional | None | $363.08 | $363.08 | $1,148.15 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,884.03 Typical High $7,244.36 | Facility | None | $1,412.54 | $2,884.03 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,000.00 | Professional | None | $602.56 | $758.58 | $1,000.00 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,691.53 | Facility | None | $602.56 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,047.13 | Professional | None | $602.56 | $741.31 | $1,047.13 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,248.07 | Professional | None | $4,677.35 | $4,677.35 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $5,248.07 | Facility | None | $630.96 | $1,862.09 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $933.25 | Professional | None | $549.54 | $660.69 | $933.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $562.34 | Professional | None | $21.88 | $117.49 | $562.34 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $4,466.84 | Facility | None | $602.56 | $2,041.74 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,047.13 | Professional | None | $588.84 | $741.31 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Professional | None | $501.19 | $660.69 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $269.15 | $302.00 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $120.23 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $407.38 | $446.68 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $478.63 |
Where Texas sits
The same service costs 3.5 times more in Wisconsin than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $7,172MT $2,070
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.